T3 - Newborn Nursing Care (Josh) Flashcards Preview

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Flashcards in T3 - Newborn Nursing Care (Josh) Deck (50):
1

What are the Four Conditions for maintaining an adequate O2 supply?

Clear airway

Establishment of respirations

Adequate circulation, perfusion, and cardiac function

Adequate thermoregulation

2

Which order do we suction the neonate?

mouth before nose

**M comes before N

3

Nursing Interventions for Neonatal Respiratory System

Support baby w/ head to side

Compress bulb syringe and suction SIDE OF MOUTH first
****avoid touching center back of mouth (gag reflex)

Suction each side of NOSE

Deeper suction w/ DeLEE x 5 secs or less

***

4

How much Vit K do we give to newborn?

0.5 - 1mg

***5/8 in needle w/ a TB syringe

5

How often is neonate body temp assessed?

q30 minutes until stable

6

Nursing actions to maintain body temp?

Position crib away from wall/windows

Perform exams under heat panel

Delay bath until temp stable

7

Which temp source?

axillary (book)

rectal (in real life sometimes)

8

Which med do we give in newborn eyes?

Erythromycin

***may also use Tetracycline 1% or Silver Nitrate 1%

***prevents inflammation r/t gonorrhea infection

9

Which med should be injected within 1 hr of birth?

Vit K (0.5 - 1 mg)

***helps w/ clotting factors

10

How long should mom wait to give a tub bath?

until cord separates (10-14 days)

11

Clean cord w/ ---.

water

***no evidence that antiseptic/antimicrobial agents help

12

Which scale is used to classify neonates based upon maturity and intrauterine growth?

Ballard Scale

13

Ballard Scale:

What constitutes preterm?

14

Ballard Scale:

What constitutes early term?

37-38.6 wks

15

Ballard Scale:

What constitutes full term?

39-40.6 wks

16

Ballard Scale:

What constitutes late term?

41-41.6

17

What does PKU test look for?

Kenicterus

***ketones in urine

18

Ballard Scale:

What constitutes post term?

42 wks or more

19

Ballard Scale:

What constitutes post mature?

over 42 wks w/ placental insufficiency effects

20

What info is needed for Ballard Scale assessment?

weeks gestation

length

weight

had circumference

21

When would the Gestational Age Assessment be done?

after transition period (~ 4 hrs)

***based on neuromuscular and physical maturity

22

Common lenght and weight of neonate?

length = 17.7 - 21.7 in

weight = 5.5 - 8.8 lb

23

What is difference b/t a Cephalhematoma and a Caput Succudanum?

Cephalhematoma – collection of blood


Caput Succudanum – collection of fluid

24

What are some common soft tissue injuries in neonates?

Cephalhematoma

Caput Succudanum

Bruising

25

The -- fontanel is diamond shaped.

The --- fontanel is triangle shaped.

Anterior

Posterior

26

What will newborn chest look like?

~ 1/2 inch smaller than head

Breast tissue present

Nipple Discharge

27

What is syndactaly?

webbing of digits

28

What will the ears be in line with?

pinna in line w/ outer canthus of eye

***low set ears a sign of Down's Syndrome

29

Genitalia assessment in neonates:

Enlarged

Discharge may be present in female neonates (pseudomenses)

Testicles descended in male neonates

30

Treatment for Hypothermia

Swaddle in double warm blankets

If temp does not respond --> return to radiant warmer per protocol

Observe for respiratory distress (cold stress increases O2 need)

Observe for signs of hypoglycemia – cold stress  uses up glucose on board

31

Which plasma glucose level in full-term infant requires intervention?

32

Before circumcision, we should hold ---

feeding

33

Which type of clamp used in circumcision makes procedure bloodless?

Yellen (Gumco) Mogen clamp

***apply petroleum jelly or antibiotic ointment afterwards

34

Which type of circumcision procedure requires no ointment?

Plastibell

35

No -- until circumcision heals.

tub baths

***do NOT clean off yellow exudate

36

Urine assessment

Usually 6-8X day if getting enough to eat

Urine pale; poorly concentrated

Document all voiding especially post circumcision

No voiding documented first 24 hours --> MD notified

37

Place neonate on which side to encourage stomach emptying?

right side

***never place on stomach (ASPARATION)

38

Conditions in which breastfeeding should be avoided?

Active TB

Hep B or Hep C

HIV

Cancer

Maternal drug use

39

Why would a drug addict mom be asked to pump?

1) they may have to use it to aid in DTs Only a very small amount will be given to the baby and ONLY if the baby is experiencing sever withdrawals and other measures have not worked.

2) other reason is to see if the mother is continuing drug use.

40

Storage of breast milk.

Rigid plastic containers

Refrigerate (48-72 hrs)

Frozen (1 mth)

***6-12 mths if deep freezer

41

How should frozen milk be thawed?

fridge

under running water

42

Type 1 DM mom will likely have a --- baby.

big

***all that sugar is transferred to baby in utero

***baby will be hypoglycemic postpartum

43

Which newborn tests are required by all states?

PKU

Hypothyroid

Hearing Screen

44

When should PKU and Hypothyroid screens be performed?

24 hrs from 1st good feeding

45

To test for PKU, infant needs to have ingested ---

milk in adequate amounts

46

Accumulation of PKU result in ---

mental retardation

***can be prevented if treatment stared early

47

What is PKU test looking for?

phenylalanine (essential amino acid) in the urine

48

What is Galactosemia?

absence of an enzyme that metabolzes galactose and that results in damage to liver, brain and eyes

***galactose is "milk sugar"

49

Treatment of Galactosemia?

eliminate breast milk

***baby cannot be safely breastfed b/c lacks the enzyme to break down galactose (milk sugar)

50

Signs of a sick infant

Lethargy

Temp > 100F

Vomiting or Green Liquid stools

Refusal of 2 feedings in a row

Depressed fontanels

Dry mucous membranes